Comparative analysis of nutrient contents of multi-micronutrient supplements marketed for children in Türkiye

Objective: The market for multi-micronutrient supplements for children is expanding rapidly in Türkiye, despite national guidelines not recommending routine supplementation for healthy, well-nourished children. A critical knowledge gap exists regarding the composition of these commercially available products and their alignment with national nutritional standards. This study aimed to analyze the contents of multi-micronutrient supplements marketed for children in Türkiye and compare them with national dietary reference values (DRV) and daily maximum limits (DML). Methods: This observational, cross-sectional study was conducted between April and May 2025. A total of 89 multi-micronutrient supplements from 27 different brands, all with specific dosage recommendations for children under 18 years old, were analyzed.. Data were collected from pharmacies in İzmir and Manisa. The declared micronutrient contents on product labels were compared with the age-specific DRVs and DMLs established by the Turkish Food Codex. Results: The most frequently included micronutrients were Vitamin C (71.9%), Vitamin D (70.8%), and Zinc (61.8%). A significant heterogeneity was observed in the micronutrient content of the products. For the 4-10 age group, essential minerals such as calcium, magnesium, and iron were often supplied at subtherapeutic doses, meeting only 22.8%, 20.6%, and 42.0% of the mean DRV, respectively. Conversely, the maximum doses in some products for the same age group significantly exceeded safety limits, reaching 467% of the DML for Vitamin A, 300% for Vitamin D, and 200% for Zinc. Conclusion: The Turkish market for pediatric multi-micronutrient supplements is characterized by a lack of standardization, which poses a dual risk to children: potential inefficacy due to subtherapeutic doses of key minerals and a risk of chronic toxicity from excessive intake of vitamins A, D, and zinc. These findings contradict national health guidelines and highlight an urgent need for stricter regulatory oversight of supplement composition and labeling, alongside stronger clinical guidance for parents to prevent both inadequate and excessive micronutrient intake.